LORETA Neurofeedback for Addiction and the Possible Neurophysiology of Psychological Processes Influenced: A Case Study and Region of Interest Analysis of LORETA Neurofeedback in Right Anterior Cingulate Cortex

Abstract

Introduction. This case study explores the efficacy of low-resolution electromagnetic tomographic (LORETA) neurofeedback (LNFB) in the right anterior cingulate cortex (ACC) as a method for addiction treatment and examines the frequency specific effects of this training in eight other regions of the cortex identified as playing an important role in substance use disorders. Methods. This case study was completed with one right-handed, 28-year-old female participant with 3 years of continuous abstinence from polysubstance abuse; her drugs of choice were heroin and alcohol, and she reported an 8-year history of alcohol abuse and a 4-year history of heroin use (IV). She completed 25 sessions of LNFB training in which she increased 14–18 Hz activity in the right ACC. We utilized electrophysiological measures to assess the increase or decrease in eight regions of interest (ROI): the right hippocampus, the right amygdaloid complex, the right orbitofrontal cortex (OFC), the right occipital lobe, the right insular cortex, the right uncus, and two regions in the left prefrontal cortex and compared them using complex linear mixed model and partial correlation procedures. Results. The data indicate significant associations between these limbic and cortical regions. The linear increase in the right ACC was in the desired direction; however, this will require more than 25 sessions to reach significance. The effects of training in the right ACC show significant increase and decrease for all frequencies in specific regions of interest. Conclusion. This is the first study of its kind to explore the relationship between these nine ROI as influenced by LNFB in the right ACC. The data suggest that these regions may play an intricate role in behaviors and characteristics involved in addiction; specific changes in the alpha frequency in limbic regions and increases in associations between regions in the theta frequency may influence personality and other behaviors associated with addictive traits. This case study illustrates the possible neural mechanisms involved in the negative self-reference associated with addiction even after a significant period of abstinence and possibly offers insight into antecedents to the onset of substance use disorders.